Unlike most amino acids, homocysteine is a harmful amino acid that is not involved in protein synthesis. It is usually formed in the body.
This harmful amino acid is converted into either cysteine or methionine, amino acids that are safe for the body. There are different interdependent pathways involved in the conversion of homocysteine. B complex vitamins are involved in these pathways.
The normal range of homocysteine levels in the blood is less than 15 micromoles per liter (mcmol/L) of blood. Some people have higher levels of homocysteine, and this leads to hyperhomocysteinemia. High levels of homocysteine are further divided into three categories
- Moderate: 15-30 mcmol/L
- Intermediate: 30-100 mcmol/L
- Severe: Levels greater than 100 mcmol/L
High levels of homocysteine are linked to an increased risk of heart disease and certain vitamin deficiencies.
Elevated levels of homocysteine in the blood are harmful to the body. This condition is termed hyperhomocysteinemia.
According to a review published in 2017 in the journal Nutrition and Metabolism, higher homocysteine levels may be a risk factor for developing certain conditions like heart disease or nutritional deficiencies.
A study reported that higher levels of homocysteine and folate deficiency are positively associated with an overall risk of developing cancer with little effect on the type of cancer.
Hyperhomocysteinemia has also been linked to osteoporosis and the progression of bone disease.
Other potential conditions associated with hyperhomocysteinemia include dementia, stroke, atherosclerosis, blood clot formation, heart attack, hypothyroidism, and epilepsy.
A family history of hyperhomocysteinemia can increase your risk of the condition. Some of the genes needed for the breakdown of homocysteine are mentioned below.
The MTHFR gene contains instructions for the production of an enzyme known as methylenetetrahydrofolate reductase. This enzyme is involved in the processing of amino acids through the MTHFR pathway. In this pathway, a compound known as 5,10-methylenetetrahydrofolate is converted into 5-methyltetrahydrofolate, which is the active form of vitamin B9. This conversion is needed for the conversion of homocysteine into methionine. Changes (or variations) in this gene can affect enzyme activity and homocysteine levels.
rs1801133
rs1801133 is a well-known single-nucleotide polymorphism or SNP found in the MTHFR gene. There are three forms (or genotypes) of this SNP:
- TT - 10-20% efficiency of folic acid processing, higher levels of homocysteine, lower levels of vitamin B12 and folate.
- CT - 65% efficiency of folic acid processing
- CC - highest efficiency of folic acid processing
People with the CC genotype are found to have normal homocysteine levels.
The MTR gene contains instructions for the production of the enzyme methionine synthase. This enzyme is needed for the conversion of homocysteine into methionine. This enzyme requires a form of vitamin B12 to function properly.
rs2275565
rs2275565 is an SNP found in the MTR gene. The T allele is found to be the risk allele and is associated with higher levels of homocysteine.
The BHMT gene contains instructions for the production of an enzyme known as Betaine-Homocysteine S-Methyltransferase. This enzyme is needed for the conversion of homocysteine into methionine.
rs3733890
rs3733890 is an SNP found in the BHMT gene. The A allele is found to be the risk allele and plays a role in elevated homocysteine levels.
Vitamin deficiency
Vitamin B6, vitamin B12, and folate deficiency are the common causes of high homocysteine levels. These vitamins are involved in the pathways responsible for the conversion of homocysteine into safer amino acids, methionine and cysteine.
Other underlying health conditions
Kidney disease, psoriasis, Crohn’s disease, and low thyroid hormone levels can lead to high levels of homocysteine.
Smoking
Studies show that smoking can lead to higher levels of homocysteine.
Alcohol
Chronic alcohol consumption is found to increase homocysteine levels and reduce vitamin B levels.
Age
Levels of homocysteine may also increase with age. A study reported that homocysteine levels were higher in patients above 65 years of age.
The symptoms vary from person to person and maybe very minimal in certain cases. Symptoms are more prevalent in children when compared to adults. The symptoms usually depend on the underlying vitamin deficiency that results in higher homocysteine levels. Common symptoms include:
- Fatigue
- Pale skin
- Weakness
- Dizziness
- Soreness
If you have been diagnosed with a vitamin deficiency causing an increase in homocysteine levels, change your diet to include rich sources of vitamin B and folic acid.
Folate-rich foods include:
- Legumes
- Kidney beans, soybeans
- Egg
- Leafy greens, asparagus, broccoli, root vegetables
- Citrus fruits, papaya, avocado, banana
- Salmon, beef liver
- Nuts and seed
- Fortified breakfast cereals
Vitamin B6-rich foods include:
- Peanuts
- Chicken, turkey
- Soya beans
- Bananas
- Potatoes
- Fortified breakfast cereals
Vitamin B12-rich foods include:
- Dairy products
- Organ meat
- Fortified breakfast cereals
- Eggs
- Fish
Doctors may also recommend supplements to meet your vitamin needs.
If people have hyperhomocysteinemia as a result of an underlying health condition, treatment is focused on managing that condition.
A simple blood test is usually recommended to test for homocysteine levels in the blood. Blood tests can detect any vitamin deficiencies that you might have. Based on the results, your doctor may recommend additional tests to find the underlying cause.
https://www.healthline.com/health/homocysteine-levels
https://www.webmd.com/heart-disease/guide/homocysteine-risk
https://www.medicalnewstoday.com/articles/homocysteine-levels
https://www.researchgate.net/publication/318138754_Methylenetetrahydrofolate_reductase_MTHFR_polymorphisms_and_predisposition_to_different_multifactorial_disorders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741875/
Vitamin B2, also called riboflavin, is an essential nutrient needed for human health. It is one of the eight B vitamins. All the B vitamins are important for good health. Vitamin B2 is a water-soluble vitamin. Being a water-soluble vitamin, it can be excreted out of the body easily. Your body only stores a small amount of riboflavin, and hence, you need to include riboflavin in your diet every day.
Vitamin B2 plays a role in
- Maintaining tissues
- Energy metabolism
- Secretion of mucus that prevents dryness induced oil secretion that leads to acne
- Absorption of zinc, which is essential for the skin
- Maintaining the structural integrity of the skin
- Protects cells from oxidative damage
- Maintenance of red blood cells
- Keeping the skin healthy
The recommended daily intake of vitamin B2 is as follows:
For adults
1.3 mg for healthy men
1.1 mg for healthy women
1.4 mg for pregnant women
1.6 mg for lactating women
For children
0.3 mg for infants up to 6 months
0.4 mg for infants between 6-12 months
0.5 mg for 1-3-year-old children
0.6 mg for 4-8-year-old children
0.9 mg for 9-13-year-old children
1.3 mg for 14-18-year-old males
1.0 mg for 14-18-year-old females
People of certain genetic types may need more vitamin B2 due to the inefficient transport in their bodies. Certain genes can help determine your risk for vitamin deficiency.
The MTHFR gene produces an enzyme called methylenetetrahydrofolate reductase. This enzyme is involved in the methylation cycle. MTHFR activates 5, 10-methylene TetraHydroFolate(THF) to 5-methyl THF, and this is needed for the conversion of homocysteine to methionine.
This protein is also involved in the conversion of folate to SAMe, which is involved in the methylation of DNA as it is the universal methylation donor. The methylation cycle is essential for various functions in the body.
Vitamin B2 is involved in the metabolism of homocysteine along with Vitamin B1. Vitamin B2 deficiency can lead to high levels of homocysteine, which is a harmful amino acid.
rs1801133
rs1801133 is a single nucleotide polymorphism or SNP found in the MTFHR gene.It is also referred to as C677T. The T allele decreases enzyme activity, with only a 10-20% efficiency in folate processing and leads to high levels of 0f homocysteine in the body.
Vitamin B2 deficiency is not very common in the US as most of the food items like milk and whole-grain cereals, which are widely consumed, contain good levels of vitamin B2.
Vitamin B2 deficiency can lead to
- Cracked lips
- Itching of skin
- Scrotal Dermatitis
- Inflammation of mouth lining
- Inflammation of the tongue
- Scaly skin
- Hair loss
- Reproductive problems
Certain food items contain vitamin B2. These include:
- Eggs
- Kidney and liver meat, lean meats
- Green vegetables like broccoli and spinach
- Cereals, grains, and bread
- Milk and yogurt
- Lima beans and peas
- Avocados
- Artichokes
- Nuts
Riboflavin is water-soluble. While cooking food, especially boiling, vitamin content may reduce. Make sure to include a daily supply of vitamin B2 rich foods to keep your skin healthy. A balanced diet is always important to keep your skin and other parts of the body healthy.
Your doctor may prescribe certain vitamin B2 supplements to overcome your deficiency apart from your diet.
https://www.medicalnewstoday.com/articles/219561
https://www.ncbi.nlm.nih.gov/books/NBK470460/
https://www.ncbi.nlm.nih.gov/pubmed/25322900
https://www.healthline.com/health/symptoms-of-vitamin-b-deficiency
https://www.bebeautiful.in/all-things-skin/everyday/benefits-of-vitamin-b-complex
https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/
Flucloxacillin is a narrow-spectrum antibiotic (antibiotics that can kill only specific kinds of bacteria).
It can be bought only on prescription and is available in the form of capsules, oral liquids, and injections.
It is not a common antibiotic used in the United States and is sold under brand names Floxapen, Flopen, Staphylex, and Flupen in different parts of the world.
This drug is commonly used to treat:
Flucloxacillin is also used before surgery to prevent infections.
Yes, your doctor may recommend flucloxacillin for treating Urinary Tract Infections (UTIs).
Flucloxacillin belongs to the group of antibiotics called penicillin.
Bacteria grow and sustain by protecting themselves from their surroundings using a cell wall.
The work of penicillin-type antibiotics is to prevent bacteria from forming cell walls.
The bacterial cell walls need a substance called peptidoglycans to give them structure.
Peptidoglycans give mesh-like structures to the walls and make them stronger.
Flucloxacillin attacks the proteins in peptidoglycans and creates holes in them.
As a result, external fluid rushes in and bursts the wall.
This destroys the bacteria and helps bring down infection levels.
Flucloxacillin is similar in effectiveness to other types of penicillin drugs.
However, it is known to be more stable than other penicillin types.
Some of the common side effects of flucloxacillin are:
One of the more severe side effects of flucloxacillin is flucloxacillin-induced delayed cholestatic hepatitis.
This condition leads to abnormal liver functioning, elevated bilirubin levels, and liver inflammation due to the use of flucloxacillin.
Flucloxacillin may also cause bloody stools and joint and muscle pain.
Flucloxacillin may interact with other drugs and lead to changes in drug efficacy or worse side effects.
Notify your doctor if you use flucloxacillin along with any of the below medicines.
The Nuclear receptor subfamily 1 group I member 2 gene (NR1I2 gene) provides instructions for producing the pregnane X receptor (PXR).
PXR identifies the presence of foreign substances in the body and increases or decreases the levels of enzymes and proteins needed for clearing these foreign substances.
rs3814055 is a Single Nucleotide Polymorphism (SNP) in the NR1I2 gene.
People with the CC genotype of this SNP have an increased risk of developing toxic liver diseases when treated with flucloxacillin compared to people with the CT and TT genotypes.
| Genotypes | Implications |
| CC | Increased risk of developing toxic liver diseases when treated with flucloxacillin |
| CT | Regular risk of developing toxic liver diseases when treated with flucloxacillin |
| TT | Regular risk of developing toxic liver diseases when treated with flucloxacillin |
Flucloxacillin may cause hypersensitivity in some.
A study analyzed the reaction of the drug in 108 patients. O
ut of them, 33 patients showed immediate hypersensitivity, and 7 had delayed hypersensitivity.
Contact your nearest ER or dial 911 if you experience any of the below hypersensitivity symptoms after consuming flucloxacillin.
It may be safe to use prescribed doses of flucloxacillin during pregnancy and breastfeeding.
It is better to talk to your doctor and get their approval before usage.
Most antibiotics may cause gastrointestinal (GI) problems.
In the process of killing harmful bacteria in the body, antibiotics like flucloxacillin also kill the good bacteria in the gut, leading to problems like diarrhea, cramping, and bloating.
You can avoid this by including probiotic foods in your diet while on flucloxacillin.
This drug causes lesser GI problems when consumed on an empty stomach.
The absorption of the medicine is also better this way.
While on the drug, you can handle GI problems better by:
Genetic testing can help understand a person’s risk of developing extreme side effects on using flucloxacillin.
This will help plan the right dosages in patients who require long-term use of the drug.
It will also help doctors weigh the risks and benefits and choose between flucloxacillin and other antibiotics.
Analyze Your Genetic Response to Flucloxacillin
Combining alcohol with flucloxacillin may worsen the gastric side effects of the drug.
Talk to your doctor if you want to consume alcohol while on this drug.
There are no adverse effects noted on using flucloxacillin while breastfeeding.
However, consult your doctor and get approval if you are lactating and use flucloxacillin.
https://www.nhs.uk/medicines/flucloxacillin/
https://en.wikipedia.org/wiki/Flucloxacillin#Drug_interactions
https://en.wikipedia.org/wiki/Penicillin#Mechanism_of_action
https://pubchem.ncbi.nlm.nih.gov/compound/Flucloxacillin#section=Transformations
https://go.drugbank.com/drugs/DB00301
https://www.nice.org.uk/bnf-uk-only
https://www.medicalnewstoday.com/articles/216798#quick_facts
https://selfdecode.com/app/gene/nr1i2/
https://www.pharmgkb.org/vip/PA166170351
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Phenytoin is an anticonvulsant or antiepileptic drug used to control certain types of seizures in epileptic patients.
It works by slowing down seizure-causing impulses in the brain.
Phenytoin is commonly available in three oral forms:
Phenytoin is also available in the injectable form and should be administered only by a healthcare provider.
The injectable form of phenytoin is used in tonic-clonic epilepticus to prevent and treat seizures before or after neurosurgery.
The dosage of phenytoin prescribed to a patient depends upon their condition and type of seizures.
A majority of phenytoin consumed gets eliminated as an inactive substance via bile.
Phenytoin is not a controlled medication.
No studies show it may be addictive or prone to abuse.
Phenytoin helps treat grand mal seizures, tonic-clonic seizures, and complex partial seizures.
In some cases, phenytoin is also used to treat irregular heartbeat associated with certain conditions.
Like most anticonvulsants, phenytoin works by preventing nerve cells (neurons) in the brain from becoming too active and thereby blocking the spread of seizures in the brain.
The neurons in the brain work at a certain rate under normal conditions.
However, these neurons are forced to work quicker than normal during a seizure.
When many neurons begin working at a rapid rate together, it leads to an uncontrollable surge and gives rise to a seizure.
Taking anticonvulsants like phenytoin prevents this uncontrollable surge, preventing a seizure.
Phenytoin prevents the neurons in the brain from firing uncontrollably together.
By preventing the overactivity of neurons in the brain, phenytoin helps block or prevent seizures.
Despite its widespread use in treating and managing epileptic conditions, phenytoin may cause side effects in some individuals.
Common side effects due to phenytoin include:
Since most epileptic patients need to take phenytoin lifelong, some long-term side effects of phenytoin include:
Serious side effects of phenytoin that require immediate medical attention include:
In some people, long-term use of phenytoin may cause gingival hyperplasia or overgrowth of gums.
The incidence of phenytoin-induced gum overgrowth lies between 3% to 93%.
In fact, around 50% of people on long-term phenytoin therapy are prone to develop gingival hyperplasia.
It may take around 2 to 3 months for the gingival overgrowth to become noticeable.
The front teeth are usually more prone to overgrowth, often leading to poor oral hygiene in people with the condition.
Phenytoin interacts with other drugs, which may change how one or both drugs work.
Drug interactions also affect the clearance of the drugs, often increasing the risk of overdosage and related symptoms.
Some significant drug interactions of phenytoin include:
Delavirdine is used in HIV treatment.
Taking delavirdine with phenytoin may significantly reduce levels of delavirdine, making it less effective in treating HIV.
Carbamazepine is an anticonvulsant.
Taking carbamazepine with phenytoin may increase the metabolism of phenytoin, often decreasing its level in blood.
Reduced phenytoin levels in the blood may result in loss of seizure control and symptoms like drowsiness, visual problems, behavioral changes, and poor muscle coordination.
Warfarin is a blood thinner, and taking it with phenytoin may increase your risk of bleeding.
Taking this combination of drugs may also increase phenytoin levels in the blood, often resulting in adverse effects due to the drug.
Cyclosporine is an immunosuppressant that prevents the rejection of donated organs.
Taking phenytoin with cyclosporine may increase the risk of organ rejection.
This drug is used to treat epilepsy and bipolar disorder.
Taking valproic acid with phenytoin may increase the risk of liver damage.
Doxycycline is a broad-spectrum antibiotic used to treat bacterial infections.
Taking phenytoin with doxycycline reduces the effectiveness of doxycycline and may cause your infection to worsen.
Complement Factor H Related 4 or CFHR4 gene gives instructions for an enzyme that plays a role in lipid transport.
rs78239784 is a single nucleotide polymorphism or SNP in the CFHR4 gene.
Patients with the GG genotype may be at a greater risk of developing phenytoin-induced maculopapular exanthema than people with GT and TT genotypes.
Cytochrome P450 family 2 subfamily C member 9 or CYP2C9 gene plays an important role in the metabolism (breaking down) of steroid hormones, fatty acids, and drugs like warfarin and phenytoin.
Some genotypes of the CYP2C9 gene reduce phenytoin clearance and increase one’s risk of developing adverse central nervous system and skin effects.
Inform your doctor if you have any of the following medical conditions:
Tell your doctor about all the medications you are currently taking to avoid adverse drug interactions and subsequent negative effects.
Nutritional and herbal supplements and vitamins may interact with phenytoin.
So, inform your doctor if you are taking any of these.
Phenytoin may harm your unborn child - so, it should be taken during pregnancy only when required.
Though studies are limited, existing research states that phenytoin passes into breast milk.
Inform your doctor if you are breastfeeding before taking phenytoin.
Genetic testing helps your doctor understand how phenytoin will affect you.
It will also help your doctor determine the right dosage of phenytoin for you.
Analyze Your Genetic Response to Phenytoin
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Carbamazepine is an anticonvulsant or antiepileptic medication used to treat seizures and nerve pain.
It is commonly prescribed for epilepsy patients.
This drug is one of the World Health Organization’s Essential medicines for 2021.
This drug is sold under the brand names Tegretol, Neurotol, and Epitol.
Sedation is a common side effect of most anticonvulsant medicines, including carbamazepine.
Carbamazepine is used to treat epilepsy (a neurological condition that causes seizures and abnormal sensations).
It is also used to treat neuropathic pain (pain caused due to nervous system damage).
Different metabolic disorders, conditions like diabetes and multiple sclerosis, physical injury or wound, and even nutritional deficiencies can cause neuropathic pain.
Carbamazepine is also used to treat certain mood disorders and episodes of mania.
Carbamazepine may also be used to treat bipolar disorder in some patients.
Studies show that this drug, by itself or in combination with other drugs, helps treat and handle the signs of bipolar disorder.
Neurons in the brain are responsible for sending electrical pulses (messages) that control movements.
During a seizure, the electrical activities in the brain fire up, and there is a sudden burst of pulses sent randomly, with no pattern.
This causes problems like jerking of limbs, stiffening of the body, uncontrolled movements, and even loss of consciousness.
Neurons have sodium channels, and these channels help these electrical pulses move from one cell to another.
Carbamazepine acts as a sodium channel blocker.
By slowing down or turning off these channels, the drug prevents random pulses from being triggered and gives the brain time to recover.
The half-life of carbamazepine is about 35 hours. It may stay in the system for up to 4 days.
Some of the common side effects of carbamazepine are:
Some of the more severe side effects of carbamazepine are:
Yes. Weight gain can be a possible side effect of carbamazepine.
A study shows that the expected weight gain while on this drug can be between 7 and 15 kg in some patients.
Studies suggest that there could be a certain degree of hearing loss (tinnitus) in some patients who had overdosed on carbamazepine.
This adverse effect has not been noticed in people who take regular doses.
Carbamazepine does not seem to cause memory dysfunction.
However, according to a study, carbamazepine levels in the blood may make it difficult to carry out long-term and complex memory access tasks.
Carbamazepine may interact with other drugs, leading to changes in drug efficacy or worsened side effects.
Notify your doctor if you are on any of the below medications along with carbamazepine.
Studies show that carbamazepine decreases vitamin D levels in the body.
Therefore, doctors may suggest vitamin D supplementation when you are on this drug. Talk to your doctor about this.
Combining carbamazepine with topiramate, another epilepsy medication, may lead to carbamazepine intoxication.
Therefore, talk to your doctor before combining these medications.
The BAG cochaperone 6 gene (BAG6 gene) provides instructions for producing a protein that plays a role in cell death.
rs750332 is a Single Nucleotide Polymorphism (SNP) in the BAG6 gene.
People with the CC and CT genotypes of this SNP have an increased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine compared to those with the TT genotype.
| Genotype | Implications |
| CC | Increased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine. |
| CT | Increased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine. |
| TT | Decreased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine. |
The MHC Class I Polypeptide-Related Sequence A gene (MICA gene) produces a stress-induced antigen protein.
Changes in the gene may lead to skin conditions like psoriasis.
rs2848716 is an SNP in the MICA gene.
People with the C allele of this gene are associated with an increased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine than those with the G allele.
| Allele | Implications |
| C | Increased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine. |
| G | Decreased risk of developing Stevens-Johnson Syndrome (SJS) when treated with carbamazepine. |
The Heat shock 70 kDa protein 1L gene (HSPA1L gene) provides instructions for producing the HSPA1L protein.
This protein is associated with cell growth, multiplication, differentiation, and death.
rs2227956 is an SNP in the HSPA1L gene.
People with the G allele of this SNP have a lesser severity of hypersensitivity when treated with carbamazepine compared to those with the A allele.
| Allele | Implications |
| G | Decreased severity of hypersensitivity when treated with carbamazepine |
| A | No such protection present when treated with carbamazepine |
The Human Leukocyte Antigen-A gene (HLA-A gene) provides instructions for producing the HLA-A protein.
This protein plays a role in determining the outcomes of infectious diseases.
rs1061235 is an SNP in the HLA-A gene.
People with the T allele of this SNP have an increased adverse response to carbamazepine compared to those with the A allele.
| Allele | Implications |
| T | Increased adverse response to carbamazepine |
| A | Decreased adverse response to carbamazepine |
Some people may be allergic to carbamazepine and experience the below signs immediately after consumption.
Call 911 or rush to the nearest ER if you experience these symptoms.
SJS is a severe skin condition that causes blisters and rashes in the skin, death of the top layer of skin, and severe pain.
Carbamazepine-induced SJS is a rare yet serious side effect of this drug.
If you notice flu-like symptoms and the development of rashes in the skin after using the drug, contact your nearest hospital right away to rule out SJS.
Carbamazepine treatment may decrease White Bood Cell (WBC) count, including the levels of neutrophils, monocytes, and lymphocytes.
Very rarely, it may cause a condition called leukopenia (very low WBC count, increasing risk of infections).
Doctors may recommend getting a complete blood count test done periodically for people on carbamazepine long-term.
A study analyzed changes in vitamin D levels in 47 epileptic children on carbamazepine.
After six months of treatment, the mean vitamin D levels in the children had reduced.
Lack of vitamin D makes it difficult for the body to absorb calcium and, as a result, leads to bone loss.
Doctors may suggest vitamin D supplementation for those on carbamazepine.
Though carbamazepine is considered one of the safer antiepileptic medications, it may increase the risk of neural tube defects (defects in the brain, spine, and spinal cord) in the fetus.
If you are pregnant and on carbamazepine, talk to your doctor to understand the risks.
Though carbamazepine may pass on in the breastmilk, there are no studies to show that it affects the growth and development of the baby.
Talk to your doctor and understand the risks of breastfeeding while on this drug.
According to the FDA, all antiepileptic drugs risk creating suicidal thoughts.
Studies show that carbamazepine may cause 5.6 to 44.8 suicide attempts per 1000 person-years.
The risk may be higher for people with existing mental health conditions.
If you have suicidal thoughts, dial 911 and get help right away.
Alcohol can make the symptoms of carbamazepine worse, including dizziness, nausea, and difficulty in concentration.
It is recommended you don’t combine alcohol and carbamazepine.
Genetic testing will help doctors predict the severity of side effects when a patient is put on carbamazepine.
It will further help plan the right doses to prevent hypersensitivity symptoms and adverse effects.
Analyze Your Genetic Response to Carbamazepine
https://pubchem.ncbi.nlm.nih.gov/compound/Carbamazepine#section=LogP
https://en.wikipedia.org/wiki/Carbamazepine#Interactions
https://medlineplus.gov/druginfo/meds/a682237.html
https://www.drugs.com/carbamazepine.html#side-effects
https://www.nhs.uk/medicines/carbamazepine/
https://www.epilepsy.com/medications/carbamazepine
https://www.epsyhealth.com/seizure-epilepsy-blog/what-happens-to-the-brain-during-a-seizure
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001021/
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Metformin is an oral prescription drug used to control blood sugar levels in diabetic patients.
It is usually used along with diet and exercise to help blood sugar control.
In some people, metformin may be used with insulin or other medications in type 2 diabetes.
However, metformin is not used in patients with Type 1 diabetes (juvenile diabetes)
Metformin is available in two oral forms– tablet and solution. Some physicians may prescribe metformin to treat PCOS or Polycystic ovary Syndrome.
Metformin is available in two forms:
Metformin is an oral drug used to treat high blood sugar levels in patients with type 2 diabetes.
They are often the first line of treatment and used in combination with diet and exercise.
In some people, metformin may be used with insulin or other antidiabetic drugs as combination therapy.
After a report in May 2020 about extended-release metformin tablets containing unacceptable levels of a probable carcinogen (cancer-causing substance), the FDA recommended some makers of metformin take their products off the US market.
During this time, many doctors stopped prescribing metformin and switched to alternatives.
Metformin belongs to the biguanide class of drugs.
It acts in the following three ways to lower blood sugar levels in people with diabetes:
You will begin to notice the effects of metformin on your body within 48 hours of taking the drug.
It can take around four to five days to experience the full effect of metformin.
The time taken by metformin to show effects on the body also depends upon the dosage of the drug taken.
Though metformin is an antidiabetic drug, it may be used to regulate the menstrual cycle in women with PCOS.
Metformin regularizes the menstrual cycle, reduces the Body Mass Index(BMI), and treats the signs of PCOS within six months of treatment.
The decision to switch from metformin to insulin is usually well-evaluated and taken by your physician.
Your doctor may switch you to insulin if your blood sugar levels are still high or metformin cannot control your type 2 diabetes.
Though metformin is a safe drug, it may cause side effects in some people.
Some commonly observed side effects of metformin include:
If these symptoms do not go away in a few days, you must inform your doctor about the same.
If you experience any of the following serious side effects of metformin, visit your doctor immediately:
There is no conclusive proof that metformin causes hair loss.
However, a 2016 study states that long-term use of metformin may cause vitamin B12 deficiency and anemia, and hair loss is a symptom of both these conditions.
According to a 2016 study, metformin results in a significant reduction in testosterone levels, which causes low sex drive and erectile dysfunction.
Metformin does not cause kidney damage.
However, metformin may have an adverse effect on the renal function of people with type 2 diabetes and moderate chronic kidney disease.
Drugs cause around 2% of pancreatitis cases; metformin therapy is not one of them.
Metformin does not have any effect on an individual’s blood pressure.
Metformin may interact with other drugs.
Drug interactions may give rise to adverse effects or reduce the expected effect of metformin.
Some significant drug interactions of metformin include:
If you take other anti-diabetic medications like insulin or glyburide, taking metformin may cause low blood sugar levels.
Diuretics, also called water pills, are routinely used to lower blood pressure levels in hypertensive patients.
Taking diuretics like furosemide and hydrochlorothiazide with metformin can reduce blood sugar-lowering effects.
Nifedipine is a calcium channel blocker used to lower and maintain optimum blood pressure levels in hypertensive patients.
Nifedipine may increase metformin levels when taken together, which may increase your risk of metformin side effects.
Nicotinic acid is a cholesterol-lowering drug.
Taking it with metformin may reduce metformin’s blood sugar-lowering effects.
Drugs like acetazolamide, brinzolamide, dorzolamide and methazolamide are used in treating glaucoma.
Taking any of these with metformin may increase your risk of lactic acidosis.
Topiramate is used to treat seizures and nerve pain.
Taking it with metformin may increase your risk for lactic acidosis.
Phenytoin is routinely used in treating seizures.
Taking it with metformin reduces metformin’s blood sugar-lowering effects and may lead to a rise in blood sugar levels.
Cimetidine is used to treat heartburn and acidity-related issues.
Taking it with metformin may increase your risk for lactic acidosis.
Other drugs like hormonal pills, isoniazid (anti-tubercular drug), phenothiazines (antipsychotic drugs), and thyroid medications may interact with metformin to lower its effects on blood sugar levels.
So, always inform your doctor if you take any of these drugs before taking metformin.
Diarrhea, vomiting, and nausea may be seen in some people taking metformin. Imodium is an anti-diarrheal drug and can be safely taken with metformin.
Glipizide, like metformin, is an anti-diabetic drug.
Taking these two drugs together may increase your risk for hypoglycemia or low blood sugar.
Hence, it is recommended that you avoid this combination.
rs12208357 is a single nucleotide polymorphism or SNP in the SLC22A1 gene.
Individuals with the CC and CT genotype of this SNP may have an increased bioavailability (the portion of the drug consumed that enters the body's circulation to bring about the desired effect) of metformin compared to those having the TT genotype.
rs72552763 is another SNP in the SLC22A1 gene.
In diabetic individuals with the GAT/del genotype, the lowest concentration of metformin in the bloodstream is lesser than those with the GAT/GAT genotype.
Individuals treated with metformin having GAT/GAT genotype may have a higher trough of metformin than those with GAT/del genotype.
Solute carrier family 47 member 1 or SLC47A1 is located on chromosome 17 and plays a role in transporting sugars, glucose, bile salts, organic acids, metal ions, and amine compounds in the body.
rs2289669 is an SNP in the SLC47A1 gene.
Diabetic individuals with the AA genotype may have an increased response to metformin than AG and GG genotypes.
Tell your doctor if you have any medical condition like kidney disease, history of heart attack, stroke, diabetic ketoacidosis, heart or liver condition.
Metformin may not be the right choice of medication in people with a few medical conditions, including the ones mentioned above.
To avoid adverse drug interactions, it is advisable that you inform your doctor about all prescription and non-prescription drugs and supplements that you may be taking.
Metformin may cause changes in your menstrual cycle and promote ovulation. This increases your chances of becoming pregnant.
If you are pregnant or plan to conceive, inform your doctor about the same.
Metformin is given during pregnancy only after evaluating the benefits vs. risks.
Metformin may pass into breast milk.
So, you must inform your doctor if you are breastfeeding before taking the drug.
It is recommended to avoid alcohol while taking metformin as it may increase your risk for lactic acidosis.
Drinking alcohol while taking metformin may increase your risk for lactic acidosis and, therefore, must be avoided.
It is best to take metformin within the expiry date printed on the box or file.
Metformin is ideally taken with food.
While it is okay to take it on an empty stomach, having it with a meal reduces the risk of stomach upset.
Genetic testing may help your doctor understand how your body may react to metformin.
In people with certain genotypes, your doctor may prescribe an alternate drug if they feel metformin may not bring about the desired effects.
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